In addition to issuing those guidelines, we awarded an Exemplar Governance cooperative agreement to DirectTrust, a governance organization that creates policy and business processes/practices for Direct exchange. Through the cooperative agreement, DirectTrust will continue and expand its work to establish and promote the adoption of security and trust “rules of the road,” including the guidelines issued by ONC for Direct exchange, operationalized via accreditation.

DirectTrust works with the Electronic Healthcare Network Accreditation Commission (EHNAC) to provide a transparent accreditation process that gives Direct service providers and their subscribers a way of knowing that exchange participants meet or exceed a set of minimum policy, security, and business practices.

By providing this information, it saves participants the time and energy needed to assess each Direct implementation. Creating a recognizable ‘seal of approval’ also reduces the need for Direct implementers to engage in one-to-one contractual arrangements before allowing information to flow between each other’s systems.

Accreditation establishes trust in Direct exchange

DirectTrust’s accreditation process also gives Direct implementers a simple way of establishing scalable technical trust via electronic trust bundle exchange. A trust bundle is a collection of anchor certificates from heath information service providers (HISPs) that comply with a baseline set of common policies and practices. This eliminates the need for participating HISPs to manually exchange and maintain trust anchors with each other.

This complement of activities outlined above not only helps to create confidence among healthcare providers using Direct exchange, it saves implementers time and money by avoiding one off contracts and mechanisms for sharing trust anchors.

We encourage HISPs to get accredited by DirectTrust and add their anchor certificates to its trust bundle to ensure the providers using their services are able to exchange information across vendor and organizational boundaries.